Can stage III colorectal cancer spread to the bones in two months?

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star68
star68 Member Posts: 3
edited April 2017 in Colorectal Cancer #1

 

Sadly my mum passed away from colorectal cancer. My mum was an independent 87 year old, she was diagnosed with stage III (cT3cN1M0) superior colorectal cancer in October. It was an invasive adenocarcinoma, with an enlargement of the rectum wall.

They did all the tests (including PET scan in December) and said there was no metastasis. Oncologist decided to treat it as palliative intention with low dose of radiotherapy treatment for four weeks. 

By the 7th session she started with low back pain which to begin with the radiotherapist said it was an isolated back ache not related to the radiotherapy, but the pain wasn't going away and medications were not strong enough to relieve the pain. After two weeks of no improvement the radiotherapist cancels the sessions because she had to be reassessed by the oncologist. We went to the oncologist appointment, my mum in a wheelchair (within two weeks she became totally dependent) begging the doctor to take her pain away.

The doctor refers her to palliative care, we asked all the questions whether radiotherapy treatment triggered the pain, he said no, and if it there was a possibility that she had metastasis, he said perhaps but they were not going to do any tests, his priority was to relieve the pain. So she was referred to palliative care team.

 

The palliative care team started her on Palexia (tapentadol) two a day one in the morning and one in the evening. Withing a week she had her dose of Palexia increased to three in the morning and three in the evening, as well as a one corticosteroid, three metamizol (analgesic) three paracetamol 1 gr plus all her regular heart medication and diuretics. She was a little better but not a great deal we were positive that my mum would improve a little.

At the end of the week she started having neck ache and was agitated again with pain. I waited a couple of days and called palliative care to come to the house (until then they were giving the prescriptions over the phone) to assess her pain I wasn't sure if my mum was just having zero pain tolerance or she was getting worse. I explained everything to them, he touched her back and she was screaming with pain but if she didn't move there was no much pain. The nurse then put a pump which the doctor said it was the same medication she was taking but in the pump so they can adjust what is the best dose for her and give it in tablet form. That first night that she had the pump she asked for a tablet in the middle of the night and we gave her what the doctor told us in case she had pain again.

Next day the nurse came back, puts more medication and gave us an antiinflammatory just in case she needed pain relieve later on. That same day in the afternoon she seemed a bit confused and very sleepy which they put down to the medication, I though she was now resting because she had no pain after all she had a lots of sleepless nights and agitation her body and mind was exhausted. I decided to call palliative care and they told me to try and wake her up other wise she would not sleep at night but I couldn't, when I was calling her she was opening her eyes and closing them again, sometimes telling me off for trying to wake her up. She had a nutritional drink in the evening went to bed and after three hours sleep she woke up complaining of shortness of breath, emergency doctor was called. A couple of minutes after they arrived they were saying that these symptoms are normal because of the drugs, as they were saying that my mum drops her head and dies. They tried to reanimate her but couldn't and finally pronounced her dead, heart failure. 

 

 


My doubts are if we didn't give radiotherapy perhaps she would still be alive, my sisters and I are so upset over this we feel betrayed by the doctors, we put all our trust in them and follow their advice and my mum started deteriorating since the radiotherapy. As well how comes she didn't have metastasis in December and the PET scan was done on the 28th of December 2016 and she has metastasis of the bones (not by test evidence but by symptoms) by the 10th of February as soon as she starts radiotherapy treatment?

Her oncologist didn't want to do any more tests so we never knew if she had metastasis, I think he was wrong not wanting to do an MRI, his priotity was to deal with the pain, but if we know what stage the cancer was we would have understood better the situation.

The doctors say it's nothing to do with the radiotherapy, but all I know is that my mum was well before treatment, has someone gone through the same or similar experience.


I would like to hear your opinions on the subject to put my mind at rest.

Thank you for reading my post.

 

Comments

  • Trubrit
    Trubrit Member Posts: 5,800 Member
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    So very sorry

    I am sorry that your mum has passed away. It is a loss that never goes away. 

    I personally cannot answer your questions succinctly. I certainly cannot answer you about the treatment she recieved from her team of Doctor's. It seems that each Oncologist, each country (are you English?) has its own way of treating Cancer. 

    Radiation does cause bone pain, and has, I beleive, been linked to mets to the bone; but from my understanding (which may or may not be right), it isn't instantaneous. My own joint pain resulting from radiation, came on months after I had finished with my six weeks treatment. 

    Even though your mother was a healthy, independant 87 year old; it is still an age when the body is preparing for its eternal rest. Sometimes, even the healthiest of us, pass on to the next life. There is of course, a chance that your mother's life was nearing completion and the treatment and pain from those last months brought it to an end as opposed to any error made by her medical team. 

    It is human nature to want to look for answers when someone we love passes away; regardless of the cause.  It is part and parcel of the grieving process, which you and your sisters find yourself in. 

    Allow yourselves time to grieve. As your emotions settle and you move to another stage of grief, you can search out answers and understanding. 

    My feelings are my own, and others here may have different or better adivce. 

    Again, please accept my heartfelt sympathies. 

    TRU

  • JanJan63
    JanJan63 Member Posts: 2,478 Member
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    I'm so sorry to hear about

    I'm so sorry to hear about your mom. I agree with Tru, I doubt even if the radiation caused that to happen it wouldn't have shown up so quickly, it would have shown up down the road. Is bone cancer something that shows up in scans? I don't know. I know my aunt had cancer that had started as lung cancer and was in her bones as it progressed. That's how they found it, she thought she'd hurt her back moving a heavy plant and the pain wouldn't go away and when they did some sort of test they found the lung cancer and realized the pain in her back was from the mets to the bones of her back. My point is that the pain came on very suddenly so what happened with your mom could just be coincidental with the pain starting after the radiation.

    There are few things worse than having to question yourself and the doctor's decisions when your mom is passed. If it was that advanced she probably didn't have long as it was and it sound like she had a relatively short period of suffering. I don't know if you can find solace in that. My mom died of pancreatic cancer and she suffered for months, my brother had esophageal cancer and he suffered much longer than my mom. I sometimes worry about how long I'll suffer once I'm at the stage of it not being treatable. That's my biggest fear, actually.

    I'm so sorry, losing a mother is so hurtful. You all must be terribly heartbroken. 

    Jan

  • zx10guy
    zx10guy Member Posts: 273 Member
    edited April 2017 #4
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    Something I don't get from

    Something I don't get from this is why does it seem the medical team was treating this a palliative.  Palliative means they were only going to treat her symptoms and make her as comfortable as can be until she passes away.  Stage 3b is very treatable with curative intent.  Because she has rectal cancer, the standard of care is radiation treatment along with FOLFOX prior to surgery.  You didn't mention if FOLFOX or 5FU was given along side the radiation treatments.  Was there any discussion of surgery?  If not or if the medical team decided to not do surgery, why?  Was it her age or other health issues?

  • star68
    star68 Member Posts: 3
    edited April 2017 #5
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    zx10guy said:

    Something I don't get from

    Something I don't get from this is why does it seem the medical team was treating this a palliative.  Palliative means they were only going to treat her symptoms and make her as comfortable as can be until she passes away.  Stage 3b is very treatable with curative intent.  Because she has rectal cancer, the standard of care is radiation treatment along with FOLFOX prior to surgery.  You didn't mention if FOLFOX or 5FU was given along side the radiation treatments.  Was there any discussion of surgery?  If not or if the medical team decided to not do surgery, why?  Was it her age or other health issues?

    Digestive surgeon suggested surgery

    Yes, they did suggest surgery but we talked about with the doctor and my mum said "no", her body wouldn't resist surgery.  She felt very weak because of her other health problems and she didn't feel strong enought.  Talking to the doctor privately without my mum, he said that the protocol to treat the cancer was chemotherapy and radiotherapy and then surgery.  In my mum's case surgery would be done without following the protocol because she was too fragile and he couldn't guarantee that a malignant cell escaped and spread the cancer.  As well too many risks for a woman her age 87 years old, and chemotherapy wasn't an option because of her heart problems.  The radiotherapy was the best option to reduce the tumor and improve the symptoms more as a palliative treatment.  

    She was referred to palliative care after suspending the radiotherapy because of her pain, it was getting worse by the day and even though the oncologist didn't know at that stage if it was metastasis, he said it could be, that some tumors are very aggresive and the treatment would be the same.  My mum had a lot of pain,and the pain kept moving from her lower back to her hips, then neck it was very strange.  I didn't think it was metastasis, sometimes I thought it could be spinal cord compression because of the tumor.

  • Helen321
    Helen321 Member Posts: 1,459 Member
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    I'm so sorry for the loss of

    I'm so sorry for the loss of your mom.  Doctors are human beings and truthfully they're just guessing.   I don't trust them, I just hope they get it right.  So far they've screwed me quite a few times.  They have no clue what will really work, they can only try different things.  The tests aren't even adcanced and so much is missed.  You have to go through the stages of grief and being angry and feeling disappointed is a normal stage.  Just do your best.  Hang in there and ask for help if it becomes too much.  There are cancer grief counselors who might be able to help you sort out these feelings.